Grand Cayman, Tuesday, 18 April 2023: The Public Health Department published its seventh monthly Public Health Spotlight on Communicable and Non-Communicable Diseases (NCDs) since the announced changed on August 31, 2022.

From the Desk of Sabrina Turner

Health for all.
That is the theme for this year’s World Health Day, celebrated in April.
Health for all has been an underlying driver in the work of the Ministry of Health and Wellness, and is a key factor fuelling our vision to revamp public health and embrace a data-driven approach to health care policies, services and education.

Behind the scenes at the Ministry, our team has been working to roll out the upcoming STEPS 2023 national health survey.  A long overdue exercise, STEPS will allow us to determine the national prevalence for non-communicable diseases (NCDs), as well as their risk factors, in Cayman.  We know that heart disease, cancer, diabetes and respiratory illnesses are responsible for the majority of deaths within our islands every year, but to date we still do not know the true impact of these NCDs within our shores.
The cost of not knowing is simply too high, and one which I know we are all unwilling to keep paying. We cannot proclaim lofty goals such as health for all without doing the work necessary to reach it.

We are doing our part, but we cannot do it alone.

To fully understand the true picture of the health of the nation, we need your support and participation.  In this issue of the Public Health Spotlight, as well as in your district, on the radio, social media and via zoom, the Ministry team is laying out the details of the STEPS 2023 national health survey so that we can ensure that we maximise participation to be able to collect good, reliable data that will help shape the future of healthcare within our islands.

The quality of the data we collect is based entirely on your participation, and data is key in achieving health for all.  Will you help shape Cayman’s healthcare?
We remain at your service.

Understanding the STEPS 2023 National Health Survey

The Ministry of Health and Wellness will be undertaking the STEPS 2023 National Health Survey from 3 June- 31 July, 2023

STEPS is a standardised tool utilised by governments around the world to determine the national prevalence for non-communicable diseases (NCDs) as well as the risk factors for those NCDs.

The Cayman Islands last undertook the STEPS Survey in 2012.  Some key results from STEPS 2012 were that 7 out of 10 adults in the Cayman Islands are overweight or obese, and as many as 40% had raised blood pressure.

Cayman has undergone some significant changes in the last ten years, not least of which has been the COVID-19 pandemic.  As such, the time has come to properly assess the health of the nation and properly determine the national prevalence for heart disease, diabetes, cancer and respiratory illnesses, all of which make up the top five leading causes death among Cayman residents.

STEPS is different from other survey tools in that it is made up of three key components.

STEP 1 is a questionnaire, where participants will be asked about their health behaviours and lifestyle choice. STEP 2 is made up of a set of in-home measurements, such as height, weight and blood pressure; and STEP 3 is made up of biochemical measurements which we obtain via a finger-prick blood measurement to determine blood sugar and cholesterol levels.

In utilising an approach that incorporates both a questionnaire and the collection of objective data (measurements) STEPS gives us insight into the connection between the health behaviours and lifestyle choices and a person’s health profile.   STEPS 2 and 3 also provide participants with a mini health screening, the results of which will be shared with participants and any potential issues will be flagged for follow up.

STEPS is a randomised survey, which means that 3,300 individuals between the ages of 18-69 will be chosen to participate.  These individuals will be chosen from all three islands- Grand, Brac and Little- and the households from each district will be chosen based on a representative sample of the population for each location.  Once a STEPS 2023 enumerator arrives at the home, he or she will utilise a special app to select the randomly participant from each household if more than one is eligible.

While the STEPS 2023 survey is designed to collect sensitive personal information, the STEPS survey will be collated and anonymised in keeping with international best practices and data protection legislation. Once the data from STEPS 1, 2 and 3 has been linked, the dataset will be anonymised and personal information will be removed. This means that no one will be able to identify any participant’s personal responses and results, and the only person who will be able to access personal health records will be the participant him/herself and any health care provider to whom they choose to release their records.

STEPS is a voluntary survey.  However, it is important to note that once chosen a participant can’t be replaced- neither by someone else in the home nor by choosing another household. Replacing participants or changing households would introduce bias into the survey, so it cannot be done.

Thus, it is crucial for all Cayman residents to be aware of the STEPS 2023 national health survey and to understand the importance of participation should they be chosen.

The results from the STEPS 2023 national health survey will allow not only the Cayman Islands Government, but health services providers, partners in health education, and NGOs to take a data driven approach to policy development, service provision, and prevention and education programming.

For more information, email [email protected]<mailto:[email protected]> or log on to www.gov.ky/steps<http://www.gov.ky/steps>

Epidemiology Corner
Covid-19 Surveillance Data
March 2023: Data as of 3 April  2023
Locally:
During March 2023, there was a small increase in the number of individuals admitted to hospital who tested positive for COVID-19 compared to February 2023. This includes both individuals admitted for morbidity relating to their SARS-CoV-2 infection, and those who test positive for COVID-19 when screened on admission and receiving care for other medical needs. There was one COVID-19 death reported in March 2023.

Avian Influenza
Chile reported a confirmed human case of avian influenza to the Pan American Health Organization/World Health Organization (PAHO/WHO) on 29th March 2023[1].The infection was caused by avian influenza A (H5) virus. The case was admitted to hospital and kept in respiratory isolation. This is the first human case of avian influenza reported in Chile, and the third human case reported in the Region of the Americas in the past year. To date, no avian or human cases have been identified in the Cayman Islands.